Press Releases
MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN 2 SUBURBAN PHILADELPHIA COUNTIES
MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN 2 SUBURBAN PHILADELPHIA COUNTIES
The Centers for Medicare & Medicaid Services (CMS) has approved a request by Aetna to expand managed care coverage to Medicare beneficiaries in two suburban Philadelphia, Pa., counties.
Aetna, based in Hartford, Conn., will begin on Jan. 1 serving beneficiaries in Chester and Delaware counties, west of Philadelphia. Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice. About 148,000 beneficiaries live in the two counties.
Aetna began serving beneficiaries in 2001 in Pennsylvania as a preferred provider organization (PPO) demonstration project. The company also has a Medicare HMO product in the counties of Bucks, Chester, Delaware, Montgomery and Philadelphia.
"We are pleased Aetna decided to serve more beneficiaries in the Philadelphia area,” HHS Secretary Tommy G. Thompson said. "Under the Medicare reform law signed by President Bush, Medicare will provide all seniors - no matter where they live - with better health insurance options, including prescription drug coverage and preventive care. The law is achieving the President's goals of strengthening and modernizing Medicare.”
The plan gives another health care choice to beneficiaries in Chester and Delaware counties. The other Medicare Advantage plans currently operating in the two counties are Keystone Health Plan East, Independence Blue Cross, United Healthcare Insurance Co. and ElderHealth of Pennsylvania.
“We want to make sure all Medicare beneficiaries, whether in a Medicare Advantage plan or fee-for-service, are receiving the highest quality health care," said CMS Administrator Mark McClellan, M.D., Ph.D. "We are doing more to guarantee that beneficiaries understand the Medicare coverage options available to them. We also are reminding beneficiaries of the need to work closely with the doctors and other health care providers that give them medical care."
Since Dec. 8, when President Bush signed the Medicare Modernization Act into law, CMS has approved 15 new contracts with Medicare health plans and 42 service area expansions. There are currently 40 applications pending for new contracts and 17 service area expansions pending.
Medicare Advantage HMOs, fee-for-service plans and PPOs are available where private companies choose to offer them. Currently, about 4.6 million Medicare beneficiaries -- out of a total of about 40 million aged and disabled Americans – have enrolled in Medicare HMOs. Original fee-for-service Medicare, currently chosen by more than 35 million beneficiaries, is available to all beneficiaries.
Medicare has a far-reaching consumer information program that includes a national toll-free phone number -- 1-800-MEDICARE (1-800-633-4227) or TTY/TDD, at 877-486-2048 -- an Internet site -- www.medicare.gov -- and a coalition of more than 200 national and local organizations to provide seniors more information.